Examination of health care services organizations

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20-1058. Examination of health care services organizations

A. The director may once in each six months for the first three years after organization and once each year thereafter, or more often if deemed necessary by the director, visit each health care services organization organized under the laws of this state to examine its financial condition, its ability to meet its liabilities and its compliance with the laws of this state affecting the conduct of its business. The director may annually similarly visit and examine, either alone or jointly with representatives of the insurance supervising departments of other states, each health care services organization not organized under the laws of this state but authorized to transact business in this state.

B. The director may in like manner examine each health care services organization applying for an initial certificate of authority to do business in this state.

C. In lieu of making an examination, the director may accept a full report of the last recent examination of a foreign or alien health care services organization, certified to by the insurance supervisory official of another state, territory, commonwealth or district of the United States.

D. The director of the department of health services may participate in the examinations and visits described in this section and section 20-1064 to review the delivery of health and medical services by the health care services organization.

E. All examinations and examination related expenses shall be borne by the health care services organization and shall be paid by the insurance examiners' revolving fund in accordance with sections 20-156 and 20-159.

F. Unless preempted under federal law or unless federal law imposes greater requirements than this section, this section applies to a provider sponsored health care services organization.


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